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2016-04-19_REPORT - M2004025
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2016-04-19_REPORT - M2004025
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Entry Properties
Last modified
8/24/2016 6:20:57 PM
Creation date
4/22/2016 9:15:46 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
M2004025
IBM Index Class Name
Report
Doc Date
4/19/2016
Doc Name
Annual Fee, Report and Map
From
Farnsworth Construction and Gravel Company
To
DRMS
Annual Report Year
2016
Email Name
SJM
Media Type
D
Archive
No
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Page 5 of 5 <br /> Division records indicate the following permittee contact information. If this information is not current,please type or print <br /> current contact information: <br /> Permittee Contact: Patricia M.Farnsworth <br /> Permittee Company: Farnsworth Construction and Gravel <br /> Company <br /> Address: 175 Hwy 133 <br /> Paonia,CO 81428 <br /> Phone Number: (970)527-4434 <br /> Fax Number: (970)527-5522 <br /> Email Address: Farnsworthconstructiongravel@gmail.com <br /> I,the undersigned,hereby state that the information provided in this report is true and accurate,and that site operations are <br /> being conducted in accordance with the Division approved mining and reclamation plans. <br /> -A412_6_ <br /> Signature of Pe ee,Corporate Officer,Owner,or Documented Designee Date <br /> M-AF-01 <br />
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